| NPI | 1043628191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: 85920) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 85920) |
| 101YM0800X Counselor, Mental Health (Licence: CA 62070) | |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2018-10-26 |